半腱肌腱转位修复膝内侧副韧带损伤

Repair of Medial Collateral Ligament Injury of Knee Joint by a Transpositional Semitendinosus Tendon

目的 探讨半腱肌腱转位在附着点上对膝内侧副韧带的断裂进行重建修复的方法和疗效。方法 对 35例膝内侧副韧带断裂患者进行手术治疗 ,采用断端直接修复 ,同时切取半腱肌腱转位在膝内侧副韧带起止点处固定的方法 ,加强修复该韧带。结果 术后随访 1～ 6a ,平均 3年 5个月 ,按改良Lysholmscale评分标准 ,分优、良、可、差四个等级 ,优良率 94 .3% ,疗效满意。结论 膝内侧副韧带损伤应早期手术以获得疗效 ,半腱肌腱止点接近内侧副韧带止点 ,强度好 ,转移后在解剖学位置上加强修复膝内侧副韧带 ,发挥了膝内侧副韧带固有的生物力学效能 ,关节功能恢复满意。

Objective To investigate the effect of transposition of semitendinosus tendon in repairing the injury of medial collateral ligament of knee joint. Methods 35 patients with a broken medial collateral ligament received operation which combined direct repairing of the sustained ligament with strengthening of the transpositional semitendinosus. Results Regarding to the modified Lysholm scale rating system, the knee joint functions were classified into four grades as excellent, good, moderate and poor. All patients were followed up for 1 to 6 years, with an average of 3 years and 5 months, 94.3% patients obtained an excellent or good results. Conclusion The injury of medial collateral ligament of knee joint should be repaired surgically in early stage so as to get a good result. The semitendiuosus is very strong and has an ending attachment adjacent to that of the medial collateral ligament on the medial upper tibia, when transposed and fixed anatomically to the attachment of the medial collateral ligament, it will exert an intrinsic biomechanically effect on the medial collateral ligament and result in a satisfactory knee joint function.